Intensive care medicine
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Intensive care medicine · Apr 2005
Comparative StudyNoninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure.
This study compared the effectiveness of noninvasive ventilation (NIV) and the risk factors for NIV failure in hypercapnic acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) vs. non-COPD conditions. ⋯ Noninvasive ventilation was more effective in preventing endotracheal intubation in hypercapnic ARF due to COPD than non-COPD conditions. High APACHE II score predicted NIV failure in both groups. Noninvasive ventilation was least effective in patients with hypercapnic ARF due to pneumonia.
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Intensive care medicine · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialAntibiotic prophylaxis of early onset pneumonia in critically ill comatose patients. A randomized study.
To evaluate if a 3-day ampicillin-sulbactam prophylaxis can reduce the occurrence of early-onset pneumonia (EOP) in comatose mechanically-ventilated patients. ⋯ Antibiotic prophylaxis with ampicillin-sulbactam significantly reduced the occurrence of EOP in critically ill comatose mechanically ventilated patients. This result should encourage a large multicenter trial to demonstrate whether ampicillin-sulbactam prophylaxis reduces patient mortality, and whether antibiotic resistance is increased in patients receiving prophylaxis.
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Intensive care medicine · Apr 2005
Multicenter Study Comparative StudyFeedback and education improve physician compliance in use of lung-protective mechanical ventilation.
Use of lung-protective mechanical ventilation (MV) by applying lower tidal volumes is recommended in patients suffering from acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). Recent data suggest that lung-protective MV may benefit non-ALI/ARDS patients as well. This study analyzed tidal volume settings in three ICUs in The Netherlands to determine the effect of feedback and education concerning use of lung-protective MV. ⋯ Feedback and education improve physician compliance in use of lung-protective MV.
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Intensive care medicine · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialOnline vs live methods for teaching difficult airway management to anesthesiology residents.
To compare the effectiveness of traditional and online teaching methods for educating anesthesiology residents in the principles and practice of difficult airway management. ⋯ Online teaching formats may be a valid alternative for teaching residents the principles and practice of difficult airway management. Interaction with instructors seems to be an important element, but it may require substantial time commitments by instructors.
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Intensive care medicine · Apr 2005
Randomized Controlled Trial Comparative Study Clinical TrialNoninvasive positive pressure ventilation in infants with upper airway obstruction: comparison of continuous and bilevel positive pressure.
This study evaluated the efficacy of noninvasive continuous positive pressure (CPAP) ventilation in infants with severe upper airway obstruction and compared CPAP to bilevel positive airway pressure (BIPAP) ventilation. ⋯ This short-term study shows that noninvasive CPAP and BIPAP ventilation are associated with a significant and comparable decrease in respiratory effort in infants with upper airway obstruction. However, BIPAP ventilation was associated with patient-ventilator asynchrony.